Waves Of National Health And Nutrition Examination Survey Research Articles

Joint effect of whole blood metals exposure with dyslipidemia in representative US adults in NHANES 2011-2020.

With little knowledge on the joint effects of metal exposure on dyslipidemia, we aimed to investigate the relationship between exposure to metal and dyslipidemia among US adults based on the National Health and Nutrition Examination Survey (NHANES). Based on the five NHANES waves (2011-2020), we selected five metals in blood as exposure, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se), which were detected by inductively coupled plasma mass spectrometry. Survey-multivariable logistic regression, generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR) were performed to determine whether dyslipidemia was associated with single metals or mixed metals. Our study included 12,526 participants aged from 20 to 80, representing 577.1 million non-institutionalized US adults. We found a positive association between several metals including Pb [adjusted odds ratio (AOR) = 1.332, 95%CI: 1.165, 1.522], total Hg (AOR = 1.264, 95%CI: 1.120, 1.427), Mn (AOR = 1.181, 95%CI: 1.046, 1.334), and Se (AOR = 1.771, 95%CI: 1.576, 1.992) and dyslipidemia. According to the WQS approach, metal mixtures were positively associated with dyslipidemia (AOR: 1.310, 95%CI: 1.216, 1.411) after a full-model adjustment. As is shown in the BKMR model, mixed metals tended to be positively associated with dyslipidemia ratios in a significant manner. Females, non-Hispanic White populations, people aged over 60, and those who did a little physical activity had a greater risk for dyslipidemia. Our findings suggest metals including Cd, Pb, Hg, Mn, and Se and their combinations may adversely affect dyslipidemia among US adults. Due to the cross-sectional nature of the study, it is possible that reverse causation may exist.

Biomarkers of organophosphate insecticides exposure and asthma in general US adults: findings from NHANES 1999-2018 data.

The limited evidence linking exposure to organophosphate insecticides (OPIs) and asthma in the general population prompted us to investigate this association. Our study focused on US adults and utilized representative samples from the National Health and Nutrition Examination Survey (NHANES). From the 7 NHANES waves (1999-2018), we detected OPIs exposure using the urinary concentrations of six metabolites of dialkyl phosphates (DAPs). To evaluate the relationship between these OPIs and asthma, we employed three statistical methods: survey-multivariable logistic regression (SMLR), generalized weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Stratified analyses were done based on the relevant variable subgroups, and sensitivity analyses were carried out to evaluate the robustness of findings. A total of 6009 adults aged from 20 to 85 years old, representing the 313.5 million adults in the non-institutionalized US population, were included in our analyses. Among them, 842 participants were determined as asthma patients with an age-adjusted prevalence of 14.2%. Our results showed that dimethyl phosphate (DMP) (adjusted odd ratio (AOR) = 1.471, 95% CI: 1.086, 1.993), diethyl phosphate (DEP) (AOR = 1.453, 95% CI: 1.118, 1.888), dimethyl thiophosphate (DMTP) (AOR = 1.454, 95% CI: 1.071, 1.973), and dimethyl dithiophosphate (DMDTP) (AOR = 1.478, 95% CI: 1.119, 1.953) had a positive correlation with asthma in adults. This association was stronger in females, non-Hispanic White populations and those with a small amount of physical activity. Our study findings indicated that exposure to OPIs may elevate the risk of asthma in US general adults. Specifically, females, individuals from non-Hispanic White backgrounds, and those with lower levels of physical activity are more susceptible to developing asthma when exposed to OPIs.

The Association between Retinopathy and Arthritis: Findings from a US National Survey 2005-2008

ABSTRACT Objective To explore the association between retinopathy and arthritis in a representative sample in the United States. Methods National Health and Nutrition Examination Survey (NHANES) is a series of biannual surveys in a nationally representative non-institutionalized population of the United States. Two waves of NHANES (2005–2008) were merged in the current analysis. Arthritis status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected among participants aged 40 years and older and retinopathy status was assessed using the Airlie House classification scheme. The association between arthritis and retinopathy was evaluated using logistic regression models. Results From 6,797 eligible participants, 4,901 had information in terms of arthritis status and gradable fundus photographs of at least 1 eye. Retinopathy was less prevalent in patients with osteoarthritis compared with those without osteoarthritis (11.9% vs 17.5%, P < .05). Participants who had osteoarthritis had 43% reduced relative risk of retinopathy compared to those without, after adjusting for covariates (Odds Ratio [OR] = 0.57, 95% Confidence Interval [CI]: 0.33–0.98). This significant association persisted among diabetic participants (OR = 0.43, 95% CI: 0.19–1.00). However, no significant associations between any arthritis, rheumatoid arthritis, other types of arthritis and retinopathy were noted. Conclusions Patients with osteoarthritis were less likely to have retinopathy when compared with those without. Further studies investigating the possible protective effects of arthritis physiology and/or arthritis treatment in retinopathy are needed.

National secular trends in ambient air volatile organic compound levels and biomarkers of exposure in the United States

BackgroundExposure to air pollution is a leading cause of global mortality. Volatile organic compounds (VOCs) are constituents of ambient air that could exert adverse health effects. ObjectiveTo examine the relationship between VOC levels in ambient air and individual-level exposure to VOCs, as assessed by urinary VOC metabolites. MethodsSecular trends in 11 ambient air VOCs (2005–2013) and individual-level metabolites of 14 VOCs (2005–2014) were assessed using National Monitoring Programs (NMP) and National Health and Nutrition Examination Survey (NHANES) data, respectively. To isolate environmental exposure, individuals reporting exposure to tobacco smoke were excluded. Quantile regression models were used to assess secular trends in VOC exposure, and survey-weighted regression models were built to identify factors associated with VOC exposure. ResultsAll annual levels of ambient VOCs decreased from 2005 to 2013 (Range: 12.5%–77.2%). However, 11 of the corresponding VOC metabolites increased during the same time (Range: 0.3%–53.6%). There was a proportional change in patterns of VOC exposure across NHANES waves, with the middle quantiles of exposure showing the largest increase. VOC exposures were significantly associated with age, sex, race, education, and physical inactivity, but not with secular VOC trends. DiscussionIn the United States, individual-level exposure to several VOCs increased between 2005 and 2014 despite a decline in ambient air VOC levels. This inverse relationship suggests that ambient VOCs are not the primary source of VOC exposure, therefore, decreasing ambient VOCs alone may not be sufficient to protect against the adverse health effects associated with VOC exposure.

Handgrip strength is associated with suicidal thoughts in men: Cross-sectional analyses from NHANES.

To investigate the association between handgrip strength and suicidal thoughts in a representative sample of the US adult population using data from the National Health and Nutrition Examination Survey (NHANES). Data from two waves of NHANES (2011-2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value from the dominant hand. Suicidal thoughts were assessed using one question "Over the last 2weeks, how often have you been bothered by the following problem: Thoughts that you would be better off dead or of hurting yourself in some way?" and dichotomized to no (not at all) and yes (several days/ more than half the days/ nearly every day). Sex-specific logistic regressions were carried out to analyze associations between handgrip strength and suicidal thoughts. Data on total of 8903 adults (mean age 47.4±0.4years) were analyzed. Each 5kg increase in handgrip strength was associated with a 16% reduced odds of having suicidal thoughts (0.84, 95% CI: 0.74-0.95) among the overall male population. These associations were stronger in male aged 20-39years (0.83, 95% CI: 0.70-0.98), and 40-64years (0.73, 95% CI: 0.63-0.85). In contrast, no associations were observed in females of all age groups. Males younger than 65years old with low handgrip strength are significantly more likely to have suicidal thoughts demonstrating a dose-response relationship. Future research is required to confirm/refute our findings and establish if strength interventions can reduce suicidal thoughts.

National Secular Trends in Ambient Air Volatile Organic Compound Levels and Biomarkers of Exposure in the United States

Abstract Background Exposure to air pollution is a leading cause of global mortality. Volatile organic compounds (VOCs) are constituents of ambient air that could exert adverse health effects. Objective To examine the relationship between VOC levels in ambient air and individual-level exposure to VOCs, as assessed by urinary VOC metabolites. Methods Secular trends in 11 ambient air VOCs (2005–2013) and individual-level metabolites of 14 VOCs (2005–2014) were assessed using National Monitoring Programs (NMP) and National Health and Nutrition Examination Survey (NHANES) data, respectively. To isolate environmental exposure, individuals reporting exposure to tobacco smoke were excluded. Quantile regression models were used to assess secular trends in VOC exposure, and survey-weighted regression models were built to identify factors associated with VOC exposure. Results All annual levels of ambient VOCs decreased from 2005 to 2013 (Range: 12.5%–77.2%). However, 11 of the corresponding VOC metabolites increased during the same time (Range: 0.3%–53.6%). There was a proportional change in patterns of VOC exposure across NHANES waves, with the middle quantiles of exposure showing the largest increase. VOC exposures were significantly associated with age, sex, race, education, and physical inactivity, but not with secular VOC trends. Discussion In the United States, individual-level exposure to several VOCs increased between 2005 and 2014 despite a decline in ambient air VOC levels. This inverse relationship suggests that ambient VOCs are not the primary source of VOC exposure, therefore, decreasing ambient VOCs alone may not be sufficient to protect against the adverse health effects associated with VOC exposure.

Examining prevalence and correlates of cigarette and marijuana co-use among young adults using ten years of NHANES data

BackgroundPrior research has documented a strong association between cigarette and marijuana use among young adults; it is critical to study patterns and risk factors for co-use. MethodsAppended, cross-sectional National Health and Nutrition Examination Survey (NHANES) data were used to assess prevalence and correlates of cigarette and marijuana co-use among young adults (ages 21–30) over a 10-year period (2005–2014). Respondents (unweighted sample = 4,948) were classified into four categories regarding past-month behavior: neither use, cigarette-only use, marijuana-only use, and co-use of both. Regression models were computed to predict these categories using three waves of NHANES (unweighted sample = 3,073). ResultsPrevalence of past-month cigarette use decreased from 30.9% in 2005–2006 to 23.7% in 2013–2014 (p = 0.024) while past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable during this time. Co-use differed significantly by gender (p < 0.001; average 12.9% men, 6.8% women). Co-users were less likely to be married, more likely to endorse non-Hispanic black racial identity, more likely to have engaged in non-marijuana drug use in their lifetime and more likely to drink alcohol monthly than cigarette-only users. Co-users were more likely to have depressive symptoms, ever use non-marijuana drugs, live with a smoker, and initiate marijuana at a younger age than marijuana-only users. ConclusionsCo-use of cigarettes and marijuana remained stable but high over a ten-year period; understanding the unique characteristics, living situations, experiences, and substance use behaviors of co-users can contribute to more effective, tailored prevention and education strategies to reduce the burden of comorbid cigarette and marijuana use.

Abstract 4256: Handgrip strength and cognitive function in elderly cancer survivors

Abstract Aim: Cancer and cancer treatment-related cognitive impairments are frequently reported in cancer survivors, presenting as lack of attention, impaired executive function and short-term money loss. The aetiology of these impairments is largely unknown. Recently, serum level of brain-derived neurotrophic factor (BDNF) has been associated with cancer related cognitive impairments. BDNF is a neurotrophin, secreted in responses to muscle contraction. Meanwhile, muscle dysfunction, characterized by muscle strength and muscle composition, is common in cancer survivors. Yet its impact on cancer survivors' cognitive function is unknown. To address this gap we evaluated for the first time the associations of muscle strength determined by handgrip with two cognitive function outcomes in cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES). Method: Data in two waves of NHANES (2011-2014) were aggregated. Handgrip strength in kilogram (kg) was measured with the Takei Digital Grip Strength Dynamometer, defined as the maximum value achieved using either hand. Data on two cognitive function tests were extracted, both were conducted among adults 60 years and older: the Animal Fluency Test (AFT) which examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) which assesses processing speed, sustained attention and working memory. Survey analysis procedures were used to account for the complex sampling design of the NHANES. Gender-specific multivariable linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depression and leisure time physical activity). For explorative purpose, we further adjusted for handgrip strength squared. Results: There were 383 cancer survivors (mean age=70.9 years, mean BMI=29.3 kg/m2) with detailed data for analyses. Prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). The prevalence of handgrip strength defined sarcopenia was 10.9% in men (&amp;lt;30kg) and 20.4 % in women (&amp;lt;20kg). Scores on AFT and DSST were 18.0 (s.e. 0.4) and 51.7 (s.e. 1.0), respectively. We observed significant linear associations of handgrip strength with both test scores in women. Each increase kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed inverted U-shape association between handgrip strength and DSST score, which peaked at handgrip strength of 40-42 kg. Conclusion: Handgrip determined muscle strength appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to identify the role of muscle on cancer related-cognitive impairments in men and women cancer survivors. Citation Format: Lin Yang, Lee Smith, Liang Hu, Graham A. Colditz, Adetunji T. Toriola, Davy Vancampfort, Mark Hamer, Brendon Stubbs, Thomas Waldhör. Handgrip strength and cognitive function in elderly cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4256.

The Relationship between Immigration Status and Cardiovascular Disease Risk Factors in United States Adults with Diabetes—A 14-Year Study

Introduction: Chronic diseases such as heart disease, stroke, and type 2 diabetes are common health issues in the U.S. About 9.4% of the U.S. population has diabetes. Research shows there is a relationship between immigration status and prevalence of chronic disease. The aim of this study is to understand the relationship between immigration status and CVD risk factors such as LDL, blood pressure, hemoglobin A1c (HbA1C), and body mass index (BMI). Methods: The study included seven waves of data from the National Health and Nutrition Examination Survey (NHANES) for individuals with diabetes, aged 20 and older between 2001-2014. Survey participants were categorized as foreign-born and U.S. born based on self-report responses. Outcome measures included BMI, blood pressure, LDL, and HbA1C, measured as part of the NHANES procedures. Survey general linear regression methods were used to model each outcome and results were weighted to calculate nationally representative estimates. Results: Approximately, 5,414 individuals (representing 22,788,949 U.S. adults) were included in the study. Twenty-seven percent of the sample were foreign-born representing about 18% of the U.S. population. After controlling for demographics, NHANES waves, access to health care, and years of residence in the U.S. foreign-born individuals had significantly lower BMI (-3.05; p&amp;lt;0.0001) and systolic blood pressure (-2.55; p=0.023). There was no significant difference in diastolic blood pressure, LDL, or HbA1C among foreign-born and U.S.-born. Conclusions: Foreign-born individuals with diabetes have lower BMI and systolic blood pressure compared to U.S.-born individuals. Prior to adjusting for access to care, foreign-born had higher LDL suggesting the importance of improving access to care and ensuring that CVD risk factors are under control. Interventions focused on lowering LDL among foreign-born individuals will be critical in lowering their cardiovascular disease risk. Disclosure A. Dawson: None. E. Garacci: None. M.N. Ozieh: None. R.J. Walker: None. L.E. Egede: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. Advisory Panel; Self; Novo Nordisk Inc..

Hand grip strength and cognitive function among elderly cancer survivors.

BackgroundWe evaluated the associations of handgrip strength and cognitive function in cancer survivors ≥ 60 years old using data from the National Health and Nutrition Examination Survey (NHANES).MethodsData in two waves of NHANES (2011–2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value achieved using either hand. Two cognitive function tests were conducted among adults 60 years and older. The Animal Fluency Test (AFT) examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) assesses processing speed, sustained attention, and working memory. Survey analysis procedures were used to account for the complex sampling design of the NHANES. Multiple linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depressive symptoms and leisure time physical activity).ResultsAmong 383 cancer survivors (58.5% women, mean age = 70.9 years, mean BMI = 29.3 kg/m2), prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). In women, each increase in kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed an inverted U-shape association where cognitive function peaked at handgrip strength of 40–42 kg.ConclusionsHandgrip strength, a modifiable factor, appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to address their causal relationship.

Associations between blood cadmium levels and cognitive function in a cross-sectional study of US adults aged 60 years or older

ObjectivesThe relationship between cadmium exposure and cognition has been well studied in children. However, the association between environmental cadmium exposure and cognitive function has not been researched extensively in older...

Abstract 3268: Obesity, circulating 25-hydroxyvitamin D, and C-reactive protein levels in cancer survivors

Abstract Aim: Circulating 25-hydroxyvitamin D (25-OHD) levels may be associated with cancer prognosis. It is, however, unclear if low 25-OHD levels in cancer survivors is a surrogate for obesity, which also influences cancer prognosis. To address this, we evaluated the associations of body mass index (BMI) with circulating 25-OHD levels among cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES). Further, we determined if this association is modified by inflammation, as determined by circulating C-reactive protein (CRP) levels, since obesity is a pro-inflammatory state and vitamin D deficiency is associated with higher inflammatory markers. Method: Data on cancer survivors in five waves of NHANES (2001-2010) were aggregated. Multiple linear regression models were used to evaluate the associations of BMI with circulating 25-OHD levels, adjusting for confounders (age, gender, race, smoking status, and season of blood draw). We stratified our analyses by CRP levels into low &amp;lt;1mg/L, moderate 1.1-3.0mg/L and high &amp;gt;3.1-9.9mg/L. Results: There were 1,306 cancer survivors (mean age=60.8 years, mean BMI=28.0 kg/m2) with detailed data for analyses. The prevalent cancer types were breast (19.6%), prostate (19.6%), cervix (10.0%), and colon (8.9%). Circulating 25-OHD levels were 7.43 nmol/L lower (95%CI: 3.06 to 11.81) among obese cancer survivors (BMI ≥30kg/m2) compared to those with BMI &amp;lt;25kg/m2. In analyses stratified by CRP levels, we observed no such association among cancer survivors with low CRP levels. However, among those with moderate and high CRP levels, obese cancer survivors had statistically significantly lower 25-OHD levels compared to those with BMI &amp;lt;25kg/m2; (-8.87, 95%CI: -16.28 to -1.24) among those with moderate CRP levels and -9.85, (95% CI: -17.00 to -2.71) among those with high CRP levels. Conclusion: Obesity is associated with lower circulating 25-OHD levels in cancer survivors. This appears, however, to be limited to those with evidence of systemic inflammation. Table 1.Multivariable-adjusted associations between BMI and ciruclating 25-OHD levels among cancer survivors in the NHANES 2001-2010 (n=1306); stratified by CRP levels.Circulating 25-OHD (nmol/L)BMI category (kg/m2)Beta-coefficient (95% CI)p*Overall, n=1306&amp;lt;25reference25.0 – 29.9-2.91 (-7.49 to 1.37)0.18≥ 30-7.43 (-11.81 to -3.06)&amp;lt;.001Low CRP levels (&amp;lt;1.0 mg/L), n=348&amp;lt;25reference25.0 – 29.9-0.64 (-9.09 to 7.91)0.88≥ 30-4.00 (-11.59 to 3.59)0.3Moderate CRP levels (1.1-3.0 mg/L), n=498&amp;lt;25reference25.0 – 29.9-2.44 (-9.27 to 4.38)0.48≥ 30-8.76 (-16.28 to -1.24)0.02High CRP levels (3.1-9.9 mg/L), n=460&amp;lt;25reference25.0 – 29.9-7.63 (-13.94 to -1.33)0.02≥ 30-9.85 (-17.00 to -2.71)0.008*Adjusted for age, gender, race, body mass index, and smoking status. Citation Format: Lin Yang, Adetunji T. Toriola. Obesity, circulating 25-hydroxyvitamin D, and C-reactive protein levels in cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3268. doi:10.1158/1538-7445.AM2017-3268

Leisure-time physical activity and circulating 25-hydroxyvitamin D levels in cancer survivors: a cross-sectional analysis using data from the US National Health and Nutrition Examination Survey

ObjectivesCirculating 25-hydroxyvitamin D (25-OHD) is associated with improved cancer prognosis in some studies, yet it may be a surrogate marker for physical activity. We investigated the associations of leisure-time physical...

A sensitivity analysis on the variability in accelerometer data processing for monitoring physical activity

BackgroundAccelerometers are gaining popularity for measuring physical activity, but there are many different ways to process accelerometer data. A sensitivity analysis was conducted to study the effect of varying accelerometer data processing protocols on estimating the association between PA level and socio-demographic characteristics using the National Health and Nutrition Examination Survey (NHANES) accelerometer data. MethodsThe NHANES waves 2003–2004 and 2005–2006 accelerometer data (n=14,072) were used to investigate the effect of changing the accelerometer non-wearing time and valid day definitions on the demographic composition of the filtered datasets and the association between physical activity (PA) and socio-demographic characteristics (sex, age, race, educational level, marital status). ResultsUnder different filtering rules (minimum number of valid day and definition of non-wear time), the demographic characteristics of the final sample varied. The proportion of participants aged 20–29 decreased from 18.9% to 15.8% when the minimum number of valid days required increased from 1 to 4 (p for trend<0.001), whereas that for aged ≥70 years increased from 18.9% to 20.6% (p for trend<0.001). Furthermore, with different filters, the effect of these demographic variables and PA varied, with some variables being significant under certain filtering rules but becoming insignificant under some other rules. ConclusionsThe sensitivity analysis showed that the significance of the association between socio-demographic variables and PA could be varied with the definition of non-wearing time and minimum number of valid days.

Associations between socioeconomic status and environmental toxicant concentrations in adults in the USA: NHANES 2001–2010

Low level chronic exposure to toxicants is associated with a range of adverse health effects. Understanding the various factors that influence the chemical burden of an individual is of critical importance to public health strategies. We investigated the relationships between socioeconomic status (SES) and bio-monitored chemical concentration in five cross-sectional waves of the U.S. National Health and Nutrition Examination Survey (NHANES).We utilised adjusted linear regression models to investigate the association between 179 toxicants and the poverty income ratio (PIR) for five NHANES waves. We then selected a subset of chemicals associated with PIR in 3 or more NHANES waves and investigated potential mediating factors using structural equation modelling.PIR was associated with 18 chemicals in 3 or more NHANES waves. Higher SES individuals had higher burdens of serum and urinary mercury, arsenic, caesium, thallium, perfluorooctanoic acid, perfluorononanoic acid, mono(carboxyoctyl) phthalate and benzophenone-3. Inverse associations were noted between PIR and serum and urinary lead and cadmium, antimony, bisphenol A and three phthalates (mono-benzyl, mono-isobutyl, mono-n-butyl). Key mediators included fish and shellfish consumption for the PIR, mercury, arsenic, thallium and perfluorononanoic acid associations. Sunscreen use was an important mediator in the benzophenone-3/PIR relationship. The association between PIR and cadmium or lead was partially mediated by smoking, occupation and diet.These results provide a comprehensive analysis of exposure patterns as a function of socioeconomic status in US adults, providing important information to guide future public health remediation measures to decrease toxicant and disease burdens within society.

Association Between Body Mass Index and Suicidal Thoughts and Attempts Among US Adolescents

Association Between Body Mass Index and Suicidal Thoughts and Attempts Among US Adolescents